SENIOR Q&A: Home care agency notes

Tuesday

Mar 14, 2017 at 8:19 AM

Q: My mother lives out of state and she receives services from a home care agency. The agency provides daily help. I only receive a phone call from the agency when there is a problem. My mother calls me often to tell me the aide she had for months left and she is unhappy. I ask my mother about her care and I do not get straight answers. Is there a way that I can look at the aides notes or notes from the nurse who visits from the agency? If I could send someone a note or someone could address my concerns I would feel less panicked when I see on caller ID it is the home care agency.

A: Talk with the home care agency. Some agencies offer a portal that allows family members to leave notes, ask questions, and read what occurred on the day the aide was at the home. For the agencies that do not offer a portal, ask if someone from the agency can arrange a monthly update call. Inquire if the person such as the nurse who oversees the aides has an email that you can send questions/concerns/comments to or update them about your worries about your mother. Tell the nurse that you are out of state and the contact with the agency is helpful to allow you peace of mind. The other option is to hire a Geriatric Care Manager/Aging Life Care Specialist that can visit your mother regularly, liaison with the agency, update you, and advocate for your mother and for you. If the agency is not fulfilling their role the Geriatric Care Manager can make arrangements for a new agency. The Geriatric Care Manager can also accompany your mother to medical appointments and speak with the medical team to give you updates and answer your questions.

Q: I read a small article in the newspaper that there was another class action suit regarding the Jimmo settlement. Can you please explain?

A: In the Jimmo settlement agreement it stated that “maintenance coverage standard which provides that skilled nursing services would be covered where such skilled nursing services are necessary to maintain the patient’s current condition or prevent or slow further deterioration so long as the beneficiary requires skilled care for the services to be safely and effectively provided.” Many facilities continued to provide skilled services when goals were met. CMS will clarify that improvement (goals are not being met) is not the only reason to keep someone on skilled services. There is a maintenance coverage standard which can allow someone to stay on their skilled benefit in a skilled facility. CMS will send out notices by Sept. 4, 2017 to facilities and publish a new website devoted to the Jimmo settlement with FAQ’s. More to come on this.

Q: My mother lives out of state and she has been going back and forth to the hospital. I am thinking about moving her closer to me. What is involved in moving my mother from her current home to my state?

A: Many people move their relative closer to family members. With organization and information the move can be quite easy. It is important to understand the services in your current state. When thinking about living options for your mother; is she moving in with you, can she continue to live alone, if she is going to an apartment/home does she need services, how to obtain the services etc? The more information you garner the better the consumer you are, which directly affects your mother when she moves. Once you have decided on where your mother is moving then the insurance needs to be explored. Some Medicare supplemental policies cover multiple states and others do not. If a new supplemental policy or Part D prescription coverage is needed get advice from the experts to help you navigate the insurance component. Talk with your mother’s local physician about a move as it is important to gather as much information on your mother’s health from all of her doctor’s. Try to obtain copies of her chart to give to the new physician in your area. Next decide on how best to have your mother move; in your car, airplane, private jet etc. Will your mother need medication to help her if she feels anxious during the move or do you need to hire someone such as a nurse to travel with your mother? There are many moving pieces to the move to make the transition smoothly at your end. A Geriatric Care Manager/Aging Life Care Specialists can help with every phrase of this process. They have the resources to help you find the best options for your mother. They have contacts in the area and can help you navigate the entire process. Go to www.aginglifecare.org to find someone in your area that has the expertise or ask an Elder Law Attorney or friends who can make a recommendation.

Debbie Gitner, LCSW, C-SWCM, is vice president of the New England Chapter of Geriatric Care Managers. Linda Sullivan, R.N., C.M.C., is a registered nurse and certified care manager. Together they are owners of ElderCare Resource Services in Marlborough, helping families navigate resources for seniors. Contact them at 508-879-7008; toll free at 866-280-2308 or visit eldercareresourceservices.com.